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Practice Transformation

Individual patients may break down or metabolize medications differently, affecting how certain ones work in some people and don’t work well in others. Genetic tests reveal those factors precisely, pointing doctors to the best medication or treatment regimen. The Department of Veterans Affairs will start offering veterans who are cancer patients the tests to inform their treatment, thanks to a $25 million grant from Denny Sanford and matched by Sanford Health. Up to 250,000 vets will be eligible to receive the testing. (USA Today) (read the blog and watch the summary video)

Evidence & Innovation

Lack of awareness, access and affordability of genetic testing has stymied efforts to put precision medicine to work for cancer treatment. Despite lower costs for genetic testing, only 15 percent of advanced-stage cancer patients undergo DNA testing, and often after they’ve endured surgery, chemo or radiation therapy without results. Advanced genetic testing can guide patient treatment to a wider variety of options that may be more effective, and can avoid unnecessary therapy while saving lives and money. (MedCityNews)
In 2017, employers paid roughly the same for health care services that the Pentagon spent on defense. Companies like Walmart, McKesson, GE and Boeing contract directly with providers for bundled care arrangements that closely tie payment to patient outcomes. The idea is to fashion care that is responsive to the payer’s values; for example, Walmart requires providers to offer integrated care delivery, take a team approach to care and include patients and their families in decisions. The lower costs and better outcomes for participating patients are stunning. (Harvard Business Review)

Policy Solutions

Gene therapy promises a new era of medicines custom-designed for the patient. Some come with a high price tag up front, but may save money in the long run. Who will pay for pricey therapeutics? The question invites policy consideration for public payers and private insurers alike. One drug maker, Spark, has proposed a way for the Centers for Medicare & Medicaid Services to allow for installment payments. (The Wall Street Journal)
Patients with chronic pain are enduring unnecessary pain because of federal guidelines designed to curb opioid overuse, providers say. More than 300 health care experts told the Centers for Disease Control and Prevention that its prescribing guidelines led insurers to refuse reimbursement and erect other obstacles to patients getting the medications they need for long-term pain. While the CDC says the guidelines are “voluntary, rather than prescriptive standards,” some states have enacted limits on opioid prescribing that go beyond the CDC’s call for “clinical decisionmaking…based on an understanding of the patient’s clinical situation, functioning and life context.” (The Washington Post)
This 3-minute video from the UNC Eshelman School of Pharmacy illustrates why we must enable comprehensive medication management in our health system—today. Watch, share and be a catalyst for change to get the medications right as a GTMRx Institute Signing Member (free).

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